NPIMap

Organization Active NPI

Koock E Jung MD PC

  • Psychiatry Physician
  • Queensbury, NY
National Provider Identifier
1821275256
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
KOOCK E JUNG MD PC
Practice address
597 Bay Road
Queensbury, NY 12804
Phone
(518) 793-1160
Fax
(518) 793-1255
NPI assigned
Jan 29, 2008
Last updated
Dec 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Koock E Jung
Title
Office Manager
Phone
(518) 793-1160

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

597 Bay Road
Queensbury, NY 12804

Mailing address

597 Bay Road
Queensbury, NY 12804
Phone (518) 793-1160

Other names 1

  • Psychotherapy Center Other name

National Provider Directory

National Provider Directory

Locations

597 Bay Rd
Queensbury, NY 12804
Phone (518) 793-1160

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1821275256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 BAY ROAD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "12804",
            "telephone_number": "518-793-1160",
            "fax_number": "518-793-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 BAY ROAD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "12804",
            "telephone_number": "518-793-1160",
            "fax_number": "518-793-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOCK E JUNG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "KOOCK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-793-1160"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychotherapy Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.